More than 30 states have approved mixed martial arts contests since New Jersey officials created formal rules for the sport in 2001, barring biting, eye gouging, head butts, finger bending and other fouls. According to Ratner, the most serious documented injury during a sanctioned mixed martial contest since those rules were set has been a broken arm.

Legislation approving the sport is also pending in New York, Massachusetts, Tennessee and Rhode Island. N.C. lawmakers legalized the sport last year.

"When it was a no-holds-barred sport, it turned people off. Putting rules with it made it a solid competition," said James Hines, the North Carolina-based promoter of "Mayhem in the Cage."

"Now rules are strictly enforced," he said. "It's like poetry in motion watching a great athlete out there doing what he does best."

The S.C. measure specifies that licensed fighters must be at least 18 years old and pass physical and medical tests before bouts.

Michael Tyler, chairman of the State Athletic Commission, believes the contests would boost the state's economy and double the number of annual contests. The commission puts on between 15 and 20 boxing events, most of them in Charleston, and roughly 30 wrestling events across the state yearly.

"All these other states are taking all these fights," he said.